case fatality rates from country to country. In general, countries with adequate medical services and liberalized abortion laws have lower abortion mortality rates.
The main problem lies in the less developed countries where women, deprived of both medical service and legal'sanction, are forced to resort to induced abortion by primitive methods under unsanitary conditions. The women themselves, unskilled neighbors, lay midwives, or medicine men perform the operation.
In the following pages, examples of abortion mortality differentials will be drawn from the experience of various regions.
Northern Europe. The longest available record of maternal mortality due to abortion is from Sweden, as shown in Table 9. This table, which includes only deaths from legal abortion, shows a definite decrease in the case fatality rate over a 25-year period. No comparable long-term information is available on illegal abortion. However, in 1950 a government-appointed committee (73) reported the following statistics based on both legal and illegal abortion in Sweden. Between 1946 and 1951, 28,447 abortions were performed; of these 46 resulted in death, producing a case fatality ratio of 0.16 percent. Combined abortion and sterilization yielded a higher fatality ratio of 0.25 percent, compared with 0.09 percent for abortion alone. The report states that in the latter years of the investigation period (1949-1951) the abortion case fatality ratio decreased to 0.06 percent, which is equal to Sweden's maternal mortality from childbirth during the year 1950. Illegal abortion in the same period resulted in a case fatality ratio of 1.7 percent, based on only 352 cases of illegal abortion, of which 6 died.
Similar abortion mortality statistics have been reported for Finland and Denmark (72, 74).
Despite the significant decline in case fatality ratios in these three north European countries, their current ratios are still higher than those in eastern
Maternal Deaths from Legal Abortions, Sweden, 1939-1964
Legal Maternal Deaths Ratio/100
Period Abortions from Abortion Abortions
1939-48 13,000 38 0.200
1949-52 23,000 25 0.108
1953-56 18,400 12 0.065
1957-60 12,100 6 0.050
1961-64 14,300 6 0.042
Source: (72).legal abortion in various countries. Unlike illegal abor-is, those which have legal sanction are done under medical supervision.